最近审阅: 23 十月 2020
最近更新: 09 六月 2018

小结

定义

病史和体格检查

关键诊断因素

  • 有变化的色素性皮损(ABCDE指征)
  • >50个良性黑素细胞痣
  • 非典型痣
  • 黑素细胞性皮损不像其周围的黑素细胞痣(“丑小鸭”现象)
  • 色素皮损、不对称、边界不清或不规则、颜色变化
  • 色素性皮损自发出血或溃疡
  • 全身性症状
  • 蓝白色萎缩斑
  • 持续性单一指(趾)甲的纵行黑甲
  • Hutchinson征
  • 固定肿大的淋巴结
  • 在途转移

危险因素

  • 黑素瘤的家族史
  • 黑素瘤的个人史
  • 皮肤癌的个人史(包括日光性损害)
  • 非典型痣的病史
  • Fitzpatrick皮肤分型I或II型(浅肤色皮肤)
  • 红色或金色头发
  • 高密度的雀斑
  • 光暴露
  • 日光浴的使用
  • 浅色眼睛
  • 良性黑素细胞痣数量的增加
  • 巨大型先天性痣
  • 免疫抑制
  • 着色性干皮病

诊断性检查

首要检查

  • 皮肤镜检查
  • 皮肤活检
更多 首要检查

需考虑的检查

  • 前哨淋巴结活检
  • 血清乳酸脱氢酶
  • 胸部 X 线检查 (CXR)
  • 胸、腹、盆腔CT扫描
  • 全身 PET 扫描
  • 脑影像学检查(CT 或 MRI)
  • BRAF突变分析
更多 需考虑的检查

治疗流程

撰稿人

Melanoma Institute Australia

The University of Sydney

Sydney

Australia

利益声明

AMM has received honoraria from Novartis and BMS. AMM is on the advisory boards of MSD and Chugai.

Melanoma Institute Australia

The University of Sydney

Royal Prince Alfred and Mater Hospitals

Sydney

Australia

利益声明

RPMS is on the advisory board for Amgen and has received honoraria from BMS.

Associate Professor of Dermatology

The University of Sydney

Sydney

Australia

利益声明

PF-P declares that he has no competing interests with the topic Melanoma. PF-P has advisory roles with Leo, Novartis, Lilly, Abbvie, Janssen, Celgene (psoriasis, atopic eczema, hidradenitis). He has been paid to do research for Incyte Europe Sarl, and clinical trials for Leo, Janssen, Kyowa Hakko Kirin, Xoma, Akaal, Amgen, Merk. PF-P has also been paid for lectures by Abbvie, Amgen, Lilly, Novartis, Janssen.

Dr Alexander M. Menzies, Dr Robyn P.M. Saw, and Dr Pablo Fernandez-Peñas would like to gratefully acknowledge Dr Philip Friedlander, Dr Hobart W. Walling, and Dr Brian L. Swick, previous contributors to this monograph. PF is a consultant for Genentech. HWW and BLS declare that they have no competing interests.

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Assistant Professor

Department of Pathology and Laboratory Medicine

University of California

Los Angeles

CA

利益声明

DC declares that he has no competing interests.

Dermatologist/Dermatologic Surgeon

President of the South Carolina Skin Cancer Center

Greenville

SC

利益声明

JB declares that he has no competing interests.

Associate Director

JCCC Women's Cancers Program Area

Jonsson Comprehensive Cancer Center at UCLA

Los Angeles

CA

利益声明

MB declares that she has no competing interests.

Medical Director

CancerPartnersUK

London

UK

利益声明

KS declares that he has no competing interests.

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